CAJ | 학술논문

目的探讨周围型小肺腺癌(癌瘤直径＜2cm)中N-乙酰半乳糖胺转移酶-3(GalNAc-T3)的表达及其预后影响因素.方法分析2006年1月至2009年6月手术证实周围型小肺腺癌患者共计108例,随访资料完整.术后对病灶组织切片采用针对GalNAc-T3免疫组织化学(IHC)染色评估标本中GalNAc-T3表达水平,分析患者临床特征及其对预后的影响.结果 GalNAc-T3低表达率为40.7％,其表达水平与组织分化程度(P＜0.05)、胸膜侵犯(P＜0.05)、淋巴转移(P=0.05)、血行转移(P＜0.01)和Noguchi病理组织分型(P＜0.05)有关,但与性别、年龄、TNM分期及血清癌胚抗原(CEA)浓度无相关(P＞0.05).单因素分析表明Noguchi病理组织分型(x2=4.845,P＜0.05)、胸膜侵袭(x2=15.975,P＜0.01)及GalNAc-T3表达(x2=8.830,P＜0.01)是影响周围型小肺腺癌患者预后相关因素,多因素分析表明胸膜侵犯[相对危险度(RR)=0.187,95％可信区间(CI):0.063～0.550]与低表达GalNAc-T3(RR=4.030,95％ CI:1.284 ～ 12.647)是影响患者预后的独立危险因素(P＜0.05).结论在周围型小肺腺癌中低表达GalNAc-T3与组织分化程度、胸膜侵犯、淋巴转移、血行转移和Noguchi病理组织分型相关,并可作为影响患者预后的预测指标.
목적 탐토주위형소폐선암(암류직경＜2cm)중N-을선반유당알전이매-3(GalNAc-T3)적표체급기예후영향인소.방법 분석2006년1월지2009년6월수술증실주위형소폐선암환자공계108례,수방자료완정.술후대병조조직절편채용침대GalNAc-T3면역조직화학(IHC)염색평고표본중GalNAc-T3표체수평,분석환자림상특정급기대예후적영향.결과 GalNAc-T3저표체솔위40.7％,기표체수평여조직분화정도(P＜0.05)、흉막침범(P＜0.05)、림파전이(P=0.05)、혈행전이(P＜0.01)화Noguchi병리조직분형(P＜0.05)유관,단여성별、년령、TNM분기급혈청암배항원(CEA)농도무상관(P＞0.05).단인소분석표명Noguchi병리조직분형(x2=4.845,P＜0.05)、흉막침습(x2=15.975,P＜0.01)급GalNAc-T3표체(x2=8.830,P＜0.01)시영향주위형소폐선암환자예후상관인소,다인소분석표명흉막침범[상대위험도(RR)=0.187,95％가신구간(CI):0.063～0.550]여저표체GalNAc-T3(RR=4.030,95％ CI:1.284 ～ 12.647)시영향환자예후적독립위험인소(P＜0.05).결론 재주위형소폐선암중저표체GalNAc-T3여조직분화정도、흉막침범、림파전이、혈행전이화Noguchi병리조직분형상관,병가작위영향환자예후적예측지표.
Objective To explore the expression of UDP-N-acetyl-alpha-D-Galactosamine:polypeptide-N-acetylgalactosaminyl transferase 3 (GalNAc-T3) and prognosis factors in small peripheral lung adenocarcinoma (＜ 2 cm).Methods The clinical data of 108 patients with lung adenocarcinoma who underwent complete surgical resection were collected between January 2006 and June 2009,and had detailed clinical follow-up information.The GalNAc-T3 expression in the primary lung adenocarcinoma specimens was detected by using immunohistochemistry (IHC).The clinical characteristics and outcomes in patients were analysed.Results The rate of low expression of GalNAc-T3 was 40.7％,and its was associated with poorly differentiated tumour (P ＜ 0.05),pleural invasion (P ＜ 0.05),lymphatic invasion (P =0.05),vascular invasion (P ＜ 0.01) and Noguchi' s subtypes (P ＜ 0.01),but not with gender,ages,concentration of carcinoembryonic antigen(CEA) and pTNM (P ＞ 0.05).Univariate survival ananlysis revealed aht Noguchi' s subtypes (x2 =4.845,P ＜ 0.05),pleural invasion (x2 =15.975,P ＜ 0.01),and low expression of GalNAc-T3 (x2 =8.830,P ＜ 0.01) were correlated with prognosis.In addition,the low expression of GalNAc-T3 [relative risk (RR) =4.030,95％ confidence interval (CI):1.284-12.647) and pleural invasion (RR =0.187,95％ CI:0.063-0.550) were significant independent prognosis factors in small peripheral adenocarcinomas patients.Conclusion The low expression of GalNAc-T3 was associated with poorly differentiated tumour,pleural invasion,lymphatic invasion,vascular invasion and Noguchi's subtypes,and may be a useful marker for predicting prognosis in small peripheral adenocarcinomas patients.